Health

Which antihypertensive drugs first - and why!

Article Abstract:

Calcium channel blockers and ACE inhibitors should be reserved for those hypertensive patients who do not respond to or cannot take diuretics and beta blockers. Calcium channel blockers and ACE inhibitors were introduced in the 1980s, and although they may reduce blood pressure, it is not yet clear whether they prolong survival. On the other hand, at least 13 large, controlled trials have shown that diuretics and beta blockers can reduce sickness and death from hypertension. Deaths from coronary artery disease have fallen 40%, and those from stroke have dropped 57%. Calcium channel blockers and ACE inhibitors may have fewer side effects, but they are more expensive, and would increase the cost of antihypertensive therapy two- to 30-fold. Two-thirds of hypertensive patients in some studies were able to tolerate diuretics and beta blockers. These drugs should be the drugs of choice in treating hypertension until the time when calcium channel blockers and ACE inhibitors are found to be as effective in reducing mortality.

Author: Alderman, Michael H.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:1992

Increased blood levels of uric acid appear to be a risk factor for death from cardiovascular disease. This was the conclusion of researchers who followed 5,926 people aged 25 to 74 years for more than 20 years. Those with the highest blood levels of uric acid had almost twice the risk of dying from cardiovascular disease after eliminating all other risk factors for cardiovascular mortality.

Author: Fang, Jing, Alderman, Michael H.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:2000

Cardiovascular diseases, Patient outcomes, Mortality, Uric acid

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The return on INVEST

Article Abstract:

A study published in 2003 showed that calcium channel blockers may be as effective as beta blockers in treating high blood pressure in patients who also have coronary artery disease. In this study, most patients were also taking and ACE inhibitor and a diuretic. Other studies have confirmed that a diuretic is the best drug to use first when treating high blood pressure.

Author: Alderman, Michael H.

Publisher:American Medical AssociationPublication Name:JAMA, The Journal of the American Medical AssociationSubject:HealthISSN:0098-7484Year:2003